Symptoma

Atypical Measles

He presented with fever, shortness of breath and a purpuric rash. Radiological investigations allowed the diagnosis of severe nodular pneumonia. [ncbi.nlm.nih.gov]

Case Presentation: A healthy 54-year-old Asian female presented with 7 days of fever accompanied by a rash that spread from her neck and face to the entire trunk and extremities for the past 5 days. [shmabstracts.com]

This was a case of adult onset of atypical measles presenting with various symptoms, in which BALF was a useful diagnostic procedure. [jstage.jst.go.jp]

The new live vaccine doesn't have this atypical presentation, at least in the way the old killed vaccine did. [whale.to]

  • Fever

    The most common admitting diagnoses were varicella, scarlet fever, meningococcemia, and Rocky Mountain spotted fever, due largely to the protean cutaneous manifestations. Roentgenographic studies showed diffuse, segmental, and nodular chest lesions. [ncbi.nlm.nih.gov]

    Pneumonia is common … Medical dictionary AMS (atypical measles syndrome) — An altered expression of measles, AMS begins suddenly with high fever, headache, cough, and abdominal pain. [medicine.academic.ru]

  • Malaise

    Prodromal symptoms of fever, malaise, myalgia, headache, nausea, and vomiting were commonly followed by coryza, sore throat, conjunctivitis, photophobia, nonproductive cough, and pleuritic pain. [ncbi.nlm.nih.gov]

    Three patients, referred to as having severe systemic reactions by Krause et al, 2 experienced fever to 103 F (39.4 C), malaise, marked local pain, swelling and erythema seven days following vaccination; these reactions lasted an average of eight days [pedsinreview.aappublications.org]

    Measles has an incubation period of approximately 8 to 12 days, which is followed by a prodromal phase of high fever, cough, coryza, conjunctivitis, and malaise. [mayomedicallaboratories.com]

    Prodromal period:  3-4 days  Non-specific symptoms: fever, malaise, anorexia, headache  Classical triad: cough, coryza, conjunctivitis (with photophobia, lacrimation) 8. [slideshare.net]

  • Edema of the Hand

    Swelling (edema) of the hands and feet may occur. [medicine.academic.ru]

    Swelling ( edema ) of the hands and feet may occur. Pneumonia is common and may persist for 3 months or more. AMS occurs in persons who were incompletely immunized against measle. [medicinenet.com]

  • Localized Pain

    Three patients, referred to as having severe systemic reactions by Krause et al, 2 experienced fever to 103 F (39.4 C), malaise, marked local pain, swelling and erythema seven days following vaccination; these reactions lasted an average of eight days [pedsinreview.aappublications.org]

  • Cardiomegaly

    A chest roentgenogram disclosed cardiomegaly and small nodular shadows throughout the chest. Non-specific ST segment changes were noted on an electrocardiogram. [jstage.jst.go.jp]

  • Exanthema

    Discussion: Measles is a highly contagious viral infection that is characterized by fever, coryza, cough, and exanthema. It is effectively preventable with MMR (measles, mumps, and rubella) vaccine. [shmabstracts.com]

    The exanthema appeared 4 days after the development of fever and existed for 6 days. The similar exanthema as that of case 1 appeared on the back of fingers, hands, feet, earlobes, and the trunk, and small hemorragic exanthema on the hard palate. [webview.isho.jp]

    Drug-induced exanthema. Onset is usually within 7 to 14 days of initiation of a course of oral medication. Figure 13. [jucm.com]

    "The data show a highly significant correlation between lack of measles exanthema [rash] and auto-immune diseases, seborrhoeic skin diseases, degenerative diseases of the bones and certain tumors ... [greenmedinfo.com]

    The skin rash (also known as an exanthem or exanthema) appears 3 to 5 days after the onset of the initial symptoms (fever, cough, runny nose, and red eyes). [rxlist.com]

Complicated and possibly hazardous workups can be avoided by awareness of this disease. [ncbi.nlm.nih.gov]

  • Multiple Pulmonary Nodules

    Pediatrics 50:712 PubMed Google Scholar Chun PKC (1978) Multiple pulmonary nodules in a young man. Chest 73:527–528 PubMed CrossRef Google Scholar Carlo J De jr, Startzman HH jr (1954) The roentgen study of the chest in measles. [link.springer.com]

Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Case 3-2019: A 70-Year-Old Woman with Fever, Headache, and Progressive Encephalopathy Caplacizumab Treatment for Acquired Thrombotic Thrombocytopenic Purpura Randomized [nejm.org]

We used the following outcomes to measure recovery: fast improvement ‐ the fever had abated within 48 hours following treatment; and marked improvement ‐ meaning the fever had abated within three to five days after treatment. [cochranelibrary.com]

Treatment Unfortunately, there is no cure for measles. [verywell.com]

[…] and Therapy Treatment is supportive, focusing on relieving common symptoms and providing nutritional support, including vitamin A supplementation. [jucm.com]

Treatment is mainly supportive, but children should also receive vitamin A supplementation. [merckmanuals.com]

What is the prognosis for measles? Most people who contract measles will recover completely. Very few people who get measles will die. People who are malnourished or immunocompromised are more likely to have complications or die. [rxlist.com]

The etiology of the measles infection in our vaccinated patient is not determined, yet the most plausible explanation is vaccine failure. [shmabstracts.com]

ETIOLOGY Measles virus An RNA virus of the genus Morbillivirus in the family of Paramyxoviridae One serotype, human’s only host Stable antigenicity Rapidly inactivated by heat and light Survival in low temperature. 4. [slideshare.net]

Consequently, pneumonia, whether due to the measles virus itself, to tuberculosis, to or another bacterial etiology, is the most frequent complication. [emedicine.medscape.com]

Cozen W, Hamilton AS, Zhao P, Salam MT, Deapen DM, et al. (2009) A protective role for early oral exposures in the etiology of young adult Hodgkin lymphoma. Blood 114: 4014-4020. [omicsonline.org]

An earlier, landmark study in the American Journal of Epidemiolog y by the Center for Disease Control’s Roger Barkin found similar disturbing results of measles’ toll on the disadvantaged. [financialpost.com]

EPIDEMIOLOGY Infection sources  Patients of acute stage and viral carriers of atypical measles Transmission  Highly contagious, approximately 90% of susceptible contacts acquire the disease.  Respiratory secretions: maximal dissemination of virus occurs [slideshare.net]

"Explosive School-based Measles Outbreak Intense Exposure May Have Resulted in High Risk, Even Among Revaccinees," Mikko Paunio (Department of Public Health, Helsinki University, published in the American Journal of Epidemiology,1998. 4. [vaclib.org]

EPIDEMIOLOGY : Before vaccine introduction in 1963 in United States, 130 million cases and 7-8 million deaths were estimated to be due to measles and 95-98% of children were infected Footnote 4 Footnote 6. [canada.ca]

Langmuir, MD, " Epidemiologic Basis for Eradication of Measles in 1967 ," Public Health Reports, vol. 82, no. 3, March 1967, p. 256. 16. [greenmedinfo.com]

[…] settings where the test may be helpful Determining acute-phase infection with rubeola (measles) virus using IgM antibody testing Aiding in the identification of nonimmune individuals through IgM antibody testing Clinical Information Discusses physiology, pathophysiology [mayomedicallaboratories.com]

Measles, a vaccine-preventable disease, is currently responsible for worldwide outbreaks mainly due to the failure to maintain high coverage of childhood immunisation. [ncbi.nlm.nih.gov]

Physicians should be aware of the atypical measles syndrome presentation in order to limit the delay of diagnosis, to avoid unnecessary investigations and to prevent the potential spread of this infectious disease. [casereports.bmj.com]

It is effectively preventable with MMR (measles, mumps, and rubella) vaccine. The etiology of the measles infection in our vaccinated patient is not determined, yet the most plausible explanation is vaccine failure. [shmabstracts.com]

Immunization with inactivated measles virus does not prevent measles virus infection. It can, however, sensitize a person so that the expression of the disease is altered, resulting in AMS. [medicinenet.com]